North Macedonia urged to adopt smoke-free laws for children

North Macedonia needs to adopt EU-aligned legislation banning smoking and vaping in public indoor spaces and then make sure people respect the law.

This is according to participants at a public debate on protecting children and young people from the harms of tobacco smoke, organized by the Parliamentary Committee on Health Care, CE Report quotes MIA.

According to Public Health Institute research findings presented at the debate, smokers make up around 40% of the local population, and only 5% of them have succeeded in becoming non-smokers in recent years. To help more people overcome the addiction, the state needs to start supporting counseling services for individuals who are trying to quit tobacco use, participants said.

In his remarks at the debate, Parliament Speaker Afrim Gashi said that a society that does not protect its children from known risks is putting its own future on the line.

"Parliament remains committed to supporting initiatives aimed at strengthening legal protection against smoking. Our shared responsibility is for the laws to be clear, applicable and in line with international standards, but also for their implementation in practice to be realistic and efficient," Gashi said.

Minister of Health Azir Aliu said the mark of a healthy society was not only modern hospitals and infrastructure but also its care for clean air for children and young people.

"If we invest in the health of young generations today, we will have fewer diseases tomorrow and a lighter financial burden on our state; more energy, innovations and economic development," Aliu said, adding that tobacco use was still the leading cause of preventable death worldwide.

Health Insurance Fund director Sasho Klekovski cited statistics showing

"Macedonia loses about 4,000 lives annually as a result of smoking tobacco or tobacco products."

He added that seven out of ten users of tobacco started using them at a young age. "We are creating lifelong addiction in minors," he said.

"Only 5% of tobacco addicts have managed to overcome their addiction on their own. I speak from personal experience when I say how important it is to get out of that addiction."

"Without changing our lifestyles, without encouraging 30-minute walks, without fighting smoking and alcohol, we will inevitably face an unsustainable health insurance situation," the Health Insurance Fund head said.

He added that people should be encouraged to become non-smokers as soon as possible.

"Treat it as a national emergency and act accordingly," Klekovski said.

Committeee chairwoman Rashela Mizrahi said smoking in adolescence was a health risk that could leave long-term consequences.

"It is our shared responsibility to provide the knowledge, support and healthy environments young people need to exist without any addictions," Mizrahi said.

Pediatrician and neonatologist Elizabeta Zisovska urged parents, grandparents, teachers, the media, public figures and policymakers to do their part in providing children and young people with smoke-free surroundings to protect their healthy development.

Obstetrician Gligor Tofoski cited World Health Organization data saying that 40% of 14-year-olds in the country were smokers even though there is a law prohibiting cigarette sales to minors.

"We also have a law prohibiting smoking in health institutions, cafes and restaurants," he recalled.

"But when we leave cafes and restaurants, we smell like cigarette smoke, because they have these quasi-open-air decks where smoking is allowed. Passive smoking is also a health problem," Tofoski said.

According to cardiologist Sasha Kjaeva Atanasova, tobacco use severely increases the death risk of heart disease or stroke. Unfortunately, she noted, "Macedonia is one of the countries with the highest smoking rates."

"It is concerning that children and young people are exposed to tobacco smoke in their homes and public spaces at a time when their cardiovascular system is developing, which creates permanent damage," Kjaeva Atanasova said.

She also said that even brief, secondhand smoke exposure triggers significant harm in non-smokers, causing blood vessel inflammation, making blood stickier and raising risks for heart attacks and strokes.

"From a public policy perspective, tobacco control is one of the most cost-effective strategies for cardiovascular disease prevention," she said.

"Comprehensive smoke-free laws, their effective enforcement, accessible smoking cessation services, taxation and strict regulation of all nicotine products lead to a reduction in hospitalizations for heart attacks and strokes," the heart doctor said.

Heart surgeon Sashko Kedev said there was an increased risk of sudden death in young people associated with electronic cigarettes as well.

"Those aerosols from electronic cigarettes contain ultrafine particles, nicotine in unpredictable concentrations, heavy metals and toxic aldehydes," Kedev said.

He added that people should not be made to breathe in secondhand smoke because of "someone's right to smoke electronic cigarettes, endangering the health of the young population and everyone else."

Speaking about introducing new smoke-free legislation, he said it was highly likely the smoking bans would be met with a lot of resistance at first.

"The government will be under great pressure. The stakes are huge. That industry is very strong. The business community supporting the industry is very influential among health authorities, the government, and the parliament," the cardiologist said.

"We should give them great support in this very heroic act of theirs to adopt and implement this law," Kedev said.

He also said smokers may complain the new smoke-free law limits their freedoms and rights.

"But your right to choose — and your freedom — comes with responsibility. There is no freedom without responsibility," he said, adding that people smoking around children and young people should know they are harming children and young people's health.

As reported by CE Report, North Macedonia honored top businesses for international contributions.